Eligibility Specialist - Ambulatory Finance

Valleywise Health•Phoenix, AZ

11h

About The Position

Under the direction of the Director of Patient Access, the Eligibility Specialist ensures that patients receiving services from Valleywise Health are properly screened for self-pay financial assistance. The role gathers thorough documentation, enters information into various systems, monitors compliance policies, and ensures accurate and timely processing of accounts while registering patients. The position obtains verification of insurance and other eligibility programs, initiates and assists patients with AHCCCS applications, and tracks and monitors their completion. It performs quality checks on eligibility and AHCCCS applications initiated in the department, ensuring applications are processed for self-pay or unverifiable payer sources. The role also performs quality assurance checks on the AHCCCS application program and works with management and staff to identify and resolve issues that may threaten billing and reimbursement. Hourly pay rate: $18.97–$27.98.

Requirements

High school diploma or GED.
At least two years of progressively responsible interviewing or investigative experience obtaining confidential information.
Direct experience with the AHCCCS application process demonstrating understanding of the required knowledge, skills, and abilities.
Valid fingerprint clearance card issued by the Arizona Department of Public Safety, or submission of a completed affidavit at hire. Applicants must complete the fingerprint clearance card application within seven days of hire and present the actual card within 90 days of applying.
Excellent data-entry skills, including 10-key by touch, and ability to type 30 words per minute accurately.
Basic math skills.
Ability to demonstrate interviewing and investigative techniques to obtain information that may not be offered.
Good verbal and written interpersonal and communication skills, including basic grammar, spelling, and punctuation.
Ability to read, write, and speak effectively in English.
Ability to handle multiple tasks simultaneously.

Nice To Haves

Insurance verification experience.
Medicaid eligibility experience.
Critical thinking skills.

Responsibilities

Screen patients for self-pay financial assistance.
Gather documentation and enter information into various systems.
Monitor and follow compliance policies.
Register patients and ensure accurate and timely processing of accounts.
Obtain verification of insurance and other eligibility programs.
Initiate AHCCCS applications and assist patients in completing them.
Track and monitor AHCCCS application completion.
Perform quality checks on eligibility and AHCCCS applications initiated in the department and ensure they are processed for self-pay or unverifiable payer sources.
Perform quality assurance checks on the AHCCCS application program.
Work with management and other staff to identify and resolve issues that threaten billing and reimbursement.